Dilatation and curettage (D&C)

 

• A dilatation and curettage (D&C) is primarily a diagnostic procedure to sample the endometrium (lining of the uterus) but may also be used to treat conditions such as incomplete miscarriage.
• The procedure removes tissue from inside the uterus (womb).
• A sample of the endometrium is helpful in diagnosis of the cause of heavy menstrual bleeding or bleeding after menopause.

About dilatation and curettage (D&C)

A dilatation and curettage (D&C) is an operation performed on women to scrape away the uterus (womb) lining. The cervix (neck) of the uterus (womb) is dilated using an instrument called a dilator. The endometrium (lining of the uterus) or contents of the uterus are removed and sent to a laboratory for analysis, if required.

Reasons for D&C

D&C can be used as a diagnostic test or as a form of treatment for a range of conditions, for instance:

• A history of abnormal menstrual bleeding, such as heavy bleeding (menorrhagia), bleeding between periods or bleeding after menopause
• Investigation of uterine infection
• Incomplete abortion (miscarriage)
• Surgical abortion when combined with suction
• Incomplete medication abortion
• Investigations of female infertility.

Procedure for D&C operation

D&C is regarded as a relatively minor procedure and can be done as day surgery, but a general anaesthetic is usually given. The typical D&C procedure includes the following steps:

• Once you are anaesthetised, your uterus is examined to determine its size and position.
• A general inspection of the vulva and walls of the vagina is performed.
• A speculum is inserted, so the walls of the vagina can be seen.
• The cervix is gently widened using surgical dilators, which allows samples to be taken from the lining of the uterus.
• The samples are sent to the laboratory for investigation.

Immediately after D&C

After surgery:

• You will be discharged home the same day in most cases.
• If you have had a general anaesthetic, you will need someone to take you home.
• You will be given instructions about self-care after the procedure.
• The treating team will arrange followup.

Complications of D&C

• Serious complications are rare. These include damage to the uterus, cervix or other pelvic organs.
• All minor procedures are accompanied by some risk.
• Some women will experience a urinary tract infection.
• You may have a reaction to the medications used, such as allergic reaction to the general anaesthesia.

Taking care of yourself at home after D&C

Be guided by your doctor or surgeon, but general suggestions include:

• Some cramping or mild abdominal discomfort is considered usual after a D&C. See your doctor if you are concerned or in pain.
• You should take any medication as advised by your doctor.
• If you are taking antibiotics, make sure to take the whole course, even if you feel well.

Two weeks after your procedure, or a few days after bleeding has stopped:

• Shower instead of taking a bath
• Avoid sexual intercourse
• Use sanitary pads instead of tampons
• Avoid going swimming
• If you experience any signs of infection (such as fever, pain or discharge), see your doctor immediately.

What happens next

D&C is used to help diagnose certain conditions. Long-term outlook depends on your medical history and the need for surgery.

The doctor will arrange follow up and timing will depend on the reason for the D&C and results.

Your doctor will let you know when the results of your laboratory tests (if any) are available.